The Party of No

One of the most striking features of the health care reform was that it was passed over the unanimous opposition of the Republican Party. This has all sorts of implications, not yet fully understood by anyone (certainly not me). To start with, it’s now clear that talk of bipartisanship, distinctions between moderate and hardline Republicans and so on, has ceased to have any meaning. If their failure to stop the health bill works against them, we may see occasional Republican votes for popular legislation that is going to get through in any case. Obama’s Employment Bill got only 6 Rep votes in the House, but passed the Senate 68-29 (or maybe 70-28) in what the NYT correctly called a rare bipartisan vote. At least the reporter on this piece, Carl Hulse, has caught up with reality, unlike the general run of Beltway pundits who still think that Obama should be pursuing bipartisanship.

In many countries, a party-line vote like this (at least on one side) would be nothing surprising. In Australia, for example, crossing the floor even once earns automatic expulsion from the Labor party and guarantees political death on the other side. But the US has never had a really tight party system, largely because, until recently,the Democrats (and before them, the Whigs) were always split on racial issues.

One problem arising from this is that the US system is more vulnerable than most to the kinds of crises that arise when one party is determined to prevent the other from governing. Passing a budget requires a majority in both Houses of Congress, and the signature of the President. If the Republicans win a majority in either House in November, it’s hard to see this happening. A repetition of the 1995 shutdown seems highly likely, and, with the financial system still very fragile, the consequences could be disastrous. The 1995 shutdown didn’t turn out too well for Newt Gingrich, but it doesn’t seem to have pushed him in the direction of moderation, and the current crop of Republicans make Newt look like a RINO.

A couple more thoughts.

The Republicans have become the Party of No in another sense. Having been the party of initiative since the election of Ronald Reagan in 1980, they are back to their more accustomed role as the party of reaction. The change can probably be dated back to the 2004 election, when Bush failed to privatize Social Security or maybe even in 2003 when electoral pressure pushed him into introducing the Prescription Drug Subsidy (a pork laden monster as you’d expect from Bush, but still an expansion of the welfare state).

The shift is certainly evident when you compare Obama’s first year in office with Clinton’s. Clinton was introducing policies demanded by the Republicans and their response (the Contract with America) was that he wasn’t doing nearly enough. Now, the Republicans have nothing of their own to offer, except more tax cuts (and, I guess, more torture). They are truly the Party of No.

Finally, a partial defense of Ezra Klein, who copped some flak from Glenn Greenwald for his suggestion that the uniformly negative Republican vote spelt an end to special interest votebuying. As Greenwald points out, this is false, and the big lobbies got to write large sections of Obama’s bill.

But, I think, Klein is right in observing that a particular kind of votebuying, what you might call ‘retail’, is on the way out. In a system with disciplined political parties, there’s not much point in buying individual members of Congress. Instead, interest groups have to work at the wholesale level, convincing party and factional leaders that their interests should be looked after. Unlike retail votebuying his is something of a zero-sum game, since whatever helps one party harms the other. Since politics is inevitably about competing interests to a large extent, interest groups are never going to go away. But there’s a case to made that it’s better tohave them work at the wholesale/party level, where the voters can hold the entire party to account.

It was good to see the vote yesterday – and then to see the win at all costs tactics of the GOP, whereby they attempted to recommit the bill. Of course, they ain’t finished yet. Yells of it isn’t constitutional sounded out, so no doubt some legal timewasting will be in the offing.

PS: Isn’t the English language rich with words for nearly any occasion, what with gems like “offing”, and “the”.
PPS: Douglas Adams provided some absent words, my favourite being “abilene”, although “chicago” comes close. My copy of “The Meaning of Liff” (correct spelling) as apparently gone the way of the dodo, but I’m fairly sure Adams also had a word for the spot behind the knee.

The house minority leader’s wrap up speech on the bill was a classic of the paranoid style in American politics! He didn’t actually say ‘death panels’, but it was clear he really seems to view this rather limited, generally corporate-friendly legislation as the deathknell of American Liberty (with the capitals!). I have no idea how anyone could hope to work with such people, nor why the US media constantly urges Obama to appease them.

@Donald Oats
ABILENE Paradox Don – google it. Replace bipartisanship and intellgent decision making and what we see is politics hobbled by within party abilene complexes.

Its such a feature of modern politics…they play the media game for their party, not the ball for the rest of us.

May they, as inidividuals, carry their guilt through their lives and become good citizens after they retire from politics (like Fraser). Will it absolve all their sins? Do they feel guilt in any personal sense? Interesting question.

The Republican party and conservatives may stand united against the health bill. But when the political debate moves onto other issues, which it will before the next election, will they stay united? I don’t think so – the past couple of weeks have revealed a nasty, racist, dishonest, obscene side of the Tea Party movement. Not all within the Republican party are going to accommodate these people.

But of course that won’t happen, because the healthcare reform bill was so popular. Oh wait. 59% of the American public were against the bill. Scratch that.

But at least we can still call the Republicans the party of “no” for their partisan opposition, can’t we? Oh wait, the bill *was* bipartisan: 34 Democrats sided with the Republicans in voting against it. Strike two.

But hey, we all know the rubes are too stupid to know what’s good for them. They need tenured government employees to tell them how to live, and the bill certainly creates a lot more of those. So don’t worry: the dumbass public will surely see the error of their ways by November and vote the statists back in with an increased majority.

as they say lies, damn lies and statistics, of that 59% of the public who were against the bill, 13% were against it because it didn’t go far enough, so actually they are quite unlikely to vote for the Republicans

Maybe it’s for the better that there is no bipartisan policy on health reform. To quote the late American satirist George Carlin, bipartisan usually means that a larger-than-usual deception is being carried out.

Treading my usual haunts I came across this rant from one of my favourite left-liberal-Democrat shock jocks (yes there are one or two). It’s the kind of craziness that warms the heart but nevertheless doesn’t allow you to suspend belief far enough to accept it.

I think the US health reforms are unconstitutional. In so far as there is a need for government intervention in the health care market it ought to be a state matter not a federal one. The US constitution is pretty clear that the federal government should have limited powers.

In terms of the actual policy I don’t know much in the way of details. However compulsory private health insurance is stupid. An income contingent HECS style government loan to those that can’t self finance their health care needs is the way to go.

I tend to agree. Instead, there should be compulsory public health insurance from the government, which then tenders out the supply of services in bulk to various service providers at various prescribed quality standards. This process whould be entirely transparent. A steeply progressive levy on income should fund this.

Having a state-based system would be stupid and likely to lead to much worse outcomes for all the stakeholders in the system, with the possible exception of Big Pharma and the HMOs.

Fran – in the context of the USA I’m not sure why you are critical of a state based approach. It has the merit of being consistent with the US constitution. The EU mostly leaves health care to the individual nation states and those state based solutions are frequently the subject of praise from social democrats. Perhaps you can help me understand why a state based approach in the US isn’t workable or sound.

In terms of compulsory government insurance I think it is no better than compulsory private insurance. To be fair there are some health events that are so extreme that insurance of one form or another is the only real funding option for most people. However the vast array of medical services that are used by most people are not for extreme events. Likewise most of us are not so poor that we couldn’t pay out own way for run of the mill medical services (especially if taxes were cut accordingly). A HECS style funding scheme (with the Medicare card retained as a payment system) means that most people would pay for most of their own medical services. They could still insure for extreme events or they could rely on HECS style debt (incured using their Medicare card) with modest income contingent repayment terms. Some people might die or never achieve sufficient earning capacity to pay down the debt, but nobody would be excluded from medical services due to financial constraints. Most of us, most of the time for most services would essentially pay out own way. Taxpayers would pick up the bad debts and any other slack in the system but the market would on the supply side be more subject to price signals.

That didn’t take long: here’s the Downfall video on the Republican’s failing to block the health care reform bill. Not as much fun as “Iemma’s Dilemma”, especially if you’re from NSW, but still pretty good.

in the context of the USA I’m not sure why you are critical of a state based approach.

Ultimately, while the vast majority of health services need to be delivered locally, the funding of services and the negotiation over price and quality ought to be a monopsony. We want the best value of money possible. Allowing a patchwork quilt approach is cwertainly fgoing to leave gaps in the system that will ultimately prejudice the interests of the public, on whose behalf the buyer trades. I can’t imagine how the state of Delaware or the District of Columbia could hope to cut the same deal with providers as California might.

Ultimately, it would be better if the EU also worked this way, but given the vast size of the markets involved, the marginal advantage is probably going to be small, and given the complexities of rival tax and welfare systems, probaly too complex to work out.

Plainly, the system has to have both safety net provision and protection against collusion between service providers and service beneficiaries at the expense of the pool and frivolous use of services.

I’d arrange matters so that there was a bulk-billing option plus full rebates for expenses incurred up to $2000 for family or individual incomes in the bottom two deciles. There would be up to three years rollover of unclaimed balances. Above that the figure would be set at $1000 and decline at a rate consistent with individuals and families in the fifth decile bearing the full cost. Non-bulk-billed services would be set at 85% rebate of the scheduled fee or the average price offered for each service offered, whichever was the lower, leaving clients (subject to the above) to pay the balance up front and claim the rest back.

Item numbers for rebate would only be given to those providers tendering for not more than 20% above the average or the independently determined efficient price, whichever was the lesser. While they could charge above this, that would be a matter for negotiation with the claimant and these moneys would not be recoverable from pooled funds. People suffering from chronic illnesses (or caring for same) would be given special provisions and have a case manager appointed to them to guide them through the processes of securing the most appropriate range of services at the best price and would be given more generous (but still means-tested) provision.

People could still take out private health insurance to “top up” if they wished, but this would not be tax-deductible.

Making the system compulsory is important so that one can avoid adverse selection problems. We want everyone, including people for whom cover is not profitable at the margins, to be covered. We also particularly want those who are socially disadvantaged to get especially good care, and especially benefit from early primary care and preventive health programs, because they are much more likely to get sick and impose upon the least flexible and most expensive of services the system provides.

TerjeP (say tay-a) :I think the US health reforms are unconstitutional. In so far as there is a need for government intervention in the health care market it ought to be a state matter not a federal one. The US constitution is pretty clear that the federal government should have limited powers.
In terms of the actual policy I don’t know much in the way of details. However compulsory private health insurance is stupid. An income contingent HECS style government loan to those that can’t self finance their health care needs is the way to go.

Oh really, how are the reforms “unconstitutional”? What is the test for the “limitation of powers”?

I mean the US has the world’s largest standing army… under control of the executive. That’s a serious concentration of power. Should the army be devolved to the state level with each US state having their own militia?

I think you are confused with the concept of separation of powers, in which the judiciary, legislation and executive branches of government have an equal and balanced role in governing.

The US constitution was designed to specifically limit the power of the executive so as to avoid a concentration of powers in the presidents role and the emergence of “tyranny”.

The system was designed in response to their experiences under the British and looked to Republican Rome as a model.

It sometimes amuses me, sometimes concerns me about how much time and attention is paid to US domestic politics in australia. I mean, who really cares? We all know that the US health system is jsut like the US political system, broken, corrupt, unaffordable. Any fix is going to be very partial and inadequate, they refuse to learn anything from anywhere else in the world, there’s not much else to know.

Wel it is still the world’s most siginficant economy and the strongest military power. It is nuclear-armed and periodically gets complete tossers as leaders. As I said yesterday, it produces more than its share of nutbags.

Fran Barlow :@wilful
Wel it is still the world’s most siginficant economy and the strongest military power. It is nuclear-armed and periodically gets complete tossers as leaders. As I said yesterday, it produces more than its share of nutbags.

It also dominates popular culture, the finance system, management theories and produces heaps of science and technology, some of which touches almost every middle class person on the planet in some way. So, what happens there, and what sort of leaders and polices they have, matters.

In health care? not really, only very distantly (thankfully). But that’s nothing like the level at which the debate is followed anyway, people’s appreciation of the minutiae of the debates is extraordinary.

You’rereading the debate two narrowly. Whither US healthcare reform was the same question as whither the US presidency an the shape of congress at one remove. All sides in the US believed this, which is why the Repugs kicked up such a fuss.

They knew that if Obama failed to deliver, his side would fall into panic and disarray and be able to be picked off in populist campaigns. They would not be able to claim they had delivered anything of substance for their supporters and the claim that the Democrats can’t govern would be raised. The rights and wrongs of the matter were somewhat secondary. Obama could not afford to be seen as losing, and the Repugs had to win to stay in the game.

This reform is a long way short of adequate, but in a US context it is a substantial step forward. For us outsiders though, that Obama won probably assures him getting a second term and may signal a new and more robust approach to policy. Financial reform is next and of course there are the coming fights over energy and environmental policy. These things matter to the world.

“Obama’s Employment Bill got only 6 Rep votes in the House, but passed the Senate 68-29 (or maybe 70-28) in what the NYT correctly called a rare bipartisan vote.”

The House is normally more partisan and polarised than the Senate, and has been for some time. That is because many House members represent gerrymandered districts that are safe for either party, and so they just need to pander to their base in order to be re-elected. In the Senate the situation is different. Because Senators represent whole states, and many Senators represent states that are not an ideal fit for their own political views or many in their party, there is a greater need for bipartisanship.

Making the system compulsory is important so that one can avoid adverse selection problems.

I don’t see this being a problem in the Medicare HECS scheme I proposed. And of course a state based system can handle it just as readily as a central government system. In terms of monopsony I think you over rate it’s significance. Mostly it is used to drive down the wages of health workers (eg nurses) but longer term it comes back to bite as less workers enter the industry and older workers exit. Over the long term I think a competitive market which recognised the worth of health care workers will deliver a better result than a monopsony that drives down wages for short term cost savings.

I don’t see this being a problem in the Medicare HECS scheme I proposed.

Not if it’s compulsory, no.

And of course a state based system can handle it just as readily as a central government system.

A state-based system is a central government system albeit with a smaller constituency and less portability and uniformity of service provision.

In terms of monopsony I think you over rate its significance.typo corrected

But you don’t have any basis for saying this. I wonder what US drug companies think of the PBS, for example. Oh wait … they don’t like it because they want the freedom to give customers a better deal … 😉

Mostly it is used to drive down the wages of health workers (eg nurses) but longer term it comes back to bite as less workers enter the industry and older workers exit.

Strictly speaking that’s not true. Yes it is true that nurses get paid less, but so do childcare workers. Specialist doctors on the other hand, get paid very handsomely indeed. But this is irrelevant to the point of whether monopsony could drive down the cost of providing services, isn’t it? And in any event, we could, if we wished, resolve pay inequities in a more conventional way. Nurses get to bargain with their employers. Awards are made when there are disputes. These feed into the costs of service providers and the efficient cost of service.

What we really want is to cut out windfall profits to people at the top of the stakeholder pyramid — suppliers of pharmaceuticals, orthopaedic surgeons, and more — we want to prevent overservicing — which is a real problem in health care delivery. Not only is it expensive but hazardous to patients and often of dubious benefit.

One problem arising from this is that the US system is more vulnerable than most to the kinds of crises that arise when one party is determined to prevent the other from governing. Passing a budget requires a majority in both Houses of Congress, and the signature of the President. If the Republicans win a majority in either House in November, it’s hard to see this happening. A repetition of the 1995 shutdown seems highly likely, and, with the financial system still very fragile, the consequences could be disastrous.

The prospects for bi-partisanship policies do not appear to be bright. Obama’s health care is, as I predicted in 2008, fairly centrist in the great scheme of things (no public option, no real effort to curb insurance companies).

Obama’s legislative program, on health, education and environment, is still way more statist than Clinton’s. There is no way that the current crop of REPs will vote for it if they have the chance to vote it down.

The politics of bi-partisanship are also looking grim. You would have to bet on the REPs winning back some seats in the 2010 mid-term elections, probably regaining control of the Senate. Wikipedia reports that such elections are somewhat like by-elections in AUS, a chance to give the govt a kick in the pants.

Midterm elections are sometimes regarded as a referendum on the sitting president’s and/or incumbent party’s performance. They usually don’t turn out well for the party of the president; over the past 17 midterm elections, the president’s party has lost an average 28 seats in the House, and an average 4 seats in the Senate.

The bum-kicking effect is likely to be exacerbated by Tea Party-animals which is exactly the kind of base-mobilising movement most likely to get out the white vote and get reactionary conservatives into office. And this type is most unlikely to produce the “let wiser heads prevail” advice most needed if financial markets head into another tail-spin.

Pr Q said:

Now, the Republicans have nothing of their own to offer, except more tax cuts (and, I guess, more torture). They are truly the Party of No.

My psephelogical instinct is that the REPs are committing slow-motion political suicide by having no positive program. Their rabble-rousing do nothingism will work in the short-term 2010, but back-fire big-time for them in the long-term 2012+. Look how Clinton bounced back from 1994 in the 1998 mid-terms.

More generally, the long-term demographics of the US electorate are working against the REPs. My commenting privileges on this blog do not extend to analysing this process but I am sure that others can work it out for themselves.

My ideological instinct is that the US will gradually embrace more welfare statism for obvious demographic reasons. I predict that Obama will reward his racial base (Africans and Mexicans) by tacking away from the Centre and more to the Centre-Left in 2012, widening and strengthening health care. He will throw a sop to SWPL brigade by putting in place some kind of wishy-washy carbon mitigation scheme.

Most voters will see that an extension of health care will not usher in the Third Reich or bring the economy to its knees so they will get used to and perhaps even demand more government services.

One 2008 prediction of mine that hasthus far failed to materialise: I argued that Obama would tend to strip resources from the warfare state and funnel them to the welfare state. This has not gone through the formality of happening, both arms of the state are growing. I dont see how the US treasury will be able to foot all these bills without raising taxes. Maybe the Chinese will stump up.

I predict that Obama will win convincingly in the 2012 elections, doing better than Bush in 2004.

I just want to go over my Obama model in to weaken or strenghthen assumptions in the light of evidence of his first couple of years.

In NOV 2008 predicted Obama would at least try to follow a Centrist bi-partisan politics in his first term, a prediction that has been largely confirmed:

Obama comes accross to me as a canny centrist populist politician. Pretty much Bill Clinton without the sleaze…

Obama will have his hands full with reconstruction rather than transformation. The US polity is in a shambles after a decade of REP iniquity and incompetence. Banks ruined, Army shot to pieces, borders leaking like sieves.

FOr the first term at least, Obama will be more janitor than Messiah.

My prediction that Obama’s health care policies would be tokenist was less than half-right.

I would be surprised if the Obama govt in its first term committed itself to more than token moves towards grand ideological committments such as universal healthcare and a green revolution. For one thing Obama has not really run on a Big Target mandate….

Most likely Obama will dedicate his first term to paying off his ethnological debts (to black Americans) and performing a few ideological stunts (the kind of “stuff that white [liberal] people like”).

The Obama health care reform bill is pretty moderate but it is a genuine move towards a “grand idelogical committment”. This implies that there Obama has some policy substance to add to his considerable political style. I have adjusted my model of Obama to reduce its “spin” component. The guy is the Real Deal, although only a moderate one.

So I am going to stick with my prediction that Obama will tilt his policies more to the Centre-Left in 2012+:

It is more likely that Obama will try and husband his political resources in the first term to build a robust political consensus for more positive change in the second term.

Its pretty clear that he will have to work on Independents “to build a robust political consensus”. I am not sure how he is travelling with this demographic. They have to be convinced that he is the real deal.

Obama has no hope of swinging conservatives. In NOV 2008 I correctly predicted something like the rise of Right-wing Tea-Party-animal movement:

But he will also remember that the US polity has a fairly large mass of (temporarily submerged) Right-wing ballast. CLinton discovered this to his dismay in 1994.

Clearly though the Tea-Party-animals are not as strong as the Contract-with-America congressman. They have failed to stop healthcare reform. So we know for sure that the US Right is much weaker in 2010 than it was in 2004.

In NOV 2008 I also predicted that Obama’s steady as she goes Centrism would confront the Right-wing REPS with political oblivion:

And the Bush Rightists (including fearful WSJ editorialists) will be more or less consigned to the DoH.

The REPs have done nothing in the past couple of years to inspire confidence.

They are now unable to mount an effective opposition to Obamaism. They have no a coherent ideology. Its fun to see how rock-ribbed individualist REPs are demanding that Obama keep his hands off their Medicare.

Nor do they have a convincing leader. Rush Limbaugh, Sarah Palin, Bobby Jindal?!.

I conclude that the US polity will default towards a moderate Centre-Left policy position as the US Right largely exhausts itself in futile stunts and demographics work their relentless political logic in the DEMs favour.

Medicare HECS does not need to be mandatory to work. It just needs to be universally available. In the same sence that prior to the Rudd reforms HECS for higher education was universally available but alternate funding options were permitted. In fact under my Medicare HECS model I would pitch for a rather high repayment rate for higher income earners to encourage them to opt out or else to claw back the funds rapidly. And the system would not preclude people paying cash for medical services or using private insurance. I would see it as a payment method that was available to all but mainly used by those with financial constrains or extreme medical expenses. Not a payment system that was mandatory and certainly not an insurance scheme. Mandatory and insurance are the wrong approach, optional and universal are the way to go.

A state-based system is a central government system albeit with a smaller constituency and less portability and uniformity of service provision.

I think you’re missing the point. A state based approach to socialised medicine honours the US constitution which says the federal government should do next to nothing. Doing it federally further undermines the relevance of fundamental US law and incrementally enables a lawless federal government. If it must be done by the Feds then the proper approach would be to amend the constitution. At least with prohibition the constitution was amended to create the relevant power. Once power is available by ignoring the constitution the shackles on government become dangereously loosened. Not that this initiative is the first to tilt the US in that direction.

The other point is that state based initiatives are ultimately more accountable.

I think you’re missing the point. A state based approach to socialised medicine honours the US constitution which says the federal government should do next to nothing.

That sentiment is obsolete and recalls days when the states resisted a Navy even though people were being ransomed by Barbary pirates.

Really, as we have seen since those days, the states are largely a bastion of resistance to progress in the US. Pretty much every small bit of progress has required Federal intervention and every reactionary organises around “states rights”.

But the US has never had a really tight party system, largely because, until recently,the Democrats (and before them, the Whigs) were always split on racial issues.

The US party system tightened up in the past generation because BOTH parties polarised on issues of class/race. No bi-partisan consensus could have survived the monumental cultural revolutions of the sixties and seventies without substantial re-aliggnment.

That said, it does considerable injustice to moderate post-war REPs to paint them as monolithically opposed to civil rights. From the fifties through mid-sixties the REPs were actually far more pro-Civil Rights than the DEMs. Wikipedia reports the partisan break down on the final vote:

This raises the interesting question of what happened to US society from 1964 through to 1968 that made the REPs swing so wildly to the Right, at least on cultural issues. They did not so much split on this issue as totally flip. Did aliens abduct their moral conscience? Its a puzzlement, for the life of me I can’t figure it out. [scratches head thoughtfully].

Really, as we have seen since those days, the states are largely a bastion of resistance to progress in the US. Pretty much every small bit of progress has required Federal intervention and every reactionary organises around “states rights”.

Baloney Fran. California: way out in front on environmental issues, bloated public sector, very progressive education policies. Would be more at home as an Australian State than a US State. Also, flat broke due to very powerful public sector unions (did I mention Californians would feel at home in Oz?).

Comparing a discretionary service — tertiary education — with an essential service — health — is not apt. Morever, edcuation serrvices have built in constraints — you have to give up work to undertake study and it costs you time. Health services not so much.

I strongly suspect that if you allowed open ended loans HECS-style that you would get massive unfunded liability and lose all control of your budget. Unless people imagine that they will be called upon to repay and in a time frame that is meaningful, the temptation simply to use disretionary services whimsically would be strong, especially in the parts of the market comprising most of the population. You’re familiar with the concept of moral hazard I take it?

In short, the system simply would not be sustainable and there would be massive overservicing.

California: way out in front on environmental issues, bloated public sector, very progressive education policies.

Yet they spend more per capita imprisoning people than educating them. Disproportionate numbers of blacks and hispanics are under edcuated and in jail. They have a three-strikes law meaning that even trivial offences can get you 25 years in jail.

I’m not sure how it would cause more overservicing than the current system which is essentially free to the user. And the government could still maintain a schedule of what amount it is willing to fund for particular services and procedures. As at present any difference in the price would need to be funded out of pocket by the individual or through private insurance. I think the moral hazard of the existing system is substantially higher.

Education is more of a public good than health care with the possible exception of vacination and the treatment of contageous diseases. As such I think the case for free medical services is actually weaker than the case for free higher education.

California is flat broke due to the electricity debacle where the opportunity was provided by ‘reforms’ and the denouement courtesy of ‘innovators’ like Enron, and the stupid referendum imposed constraint on raising revenue. Maybe you should blame the looney people who promoted those bright ideas. Those people, there called libertarians.

So called ‘lefties’ might be none so bright but those who have been making all the running in the silliness stakes since the mid ’70s have been libertarians.

Libertarian couldn’t think of a pertinent observation and after offering a red herring and missing the point tried:

I love lefties. They’re so f***ing dumb.

We’re not so ‘dumb’ we miss what a conservative libertarian (TM) looks like when (s)he has no material. Libertarian’s conxession that (s)he ‘loves’ the stupid is a remarkably candid or careless admission of the conservative libertarian (TM) cultural paradigm.

I think the moral hazard of the existing system is substantially higher.

Perhaps you do, but you’d be guessing based on nothing at all. The impediments to exercising funded education are considerably higher that in medicine. To get an education service you have to make considerable personal commitments. Not so in the case of your model of health spending. If one is not going to pay back any substantial portion of a loan, and if one’s lifestyle is not affected by it, does it really matter how large the debt is? Is not paying back $100K worse than not paying back $50K?

I see no mechanism in your system for cost control or even cost prediction.

the case for free medical services is actually weaker …

You need to argue this claim with someone who actually proposes doing this. The issue about which service is essential/more important is a different thing entirely.

Fran – you have misunderstood me. I was not suggesting that the existing education funding model has lots of moral hazard. I was suggesting that the existing Medicare system has more moral hazard than my suggested alternative. It is true that under my alternate model some people may run up medical debts with no prospect or care about ever repaying them. However at the moment over use of the system isn’t even accounted for at all so we wouldn’t be increasing moral hazard. In fact most people would face the prospect of having to repay the debt and so for the bulk of the population moral hazard would be lower.

Jack Strocchi :
This raises the interesting question of what happened to US society from 1964 through to 1968 that made the REPs swing so wildly to the Right, at least on cultural issues. They did not so much split on this issue as totally flip. Did aliens abduct their moral conscience? Its a puzzlement, for the life of me I can’t figure it out. [scratches head thoughtfully].

I have only a minimal interest in US racial politics but could the The Southernstrategy have something to do with it?

Not quite accurate. At the moment, Medicare refunds 85% of scheduled fee (which might or might not be 85% of what they paid) — so they pay up front. Bulk-billed items are cost-regulated. You get about $1000 as a tax deduction for out of pocket medical expenses and then you pay the rest. You also pay for basic hospital upfront and private separately. Some pharmaceuticals are subsidised under PBS.

So although they don’t repay, there are constraints on running up expenses.

Fran – I’m not looking to increase or change the amount covered by Medicare. If Medicare today covers 85% of the cost then it would still do so under my proposed reform. It is just that the 85% would become an income contingent liability. My reform reduces moral hazard.

Well if that is all you are claiming, then really, all you are proposing is some clawback on some costs from some people. This doesn’t really address the priocesses driving costs in the first place. Not so much a reform as a twiddling of the cost-recovery knobs.

Fran – no I don’t think that is right. If a significant number of people are going to have the cost of services clawed back over time than those people will now have some cost consiousness. There will be a cost signal even if not as pure as in a free market. There will also no longer be any rivalry between private insurance and public insurance. You can take out private insurance to avoid all costs if you wish. I imagine that many would and that over time the Medicare HECS system would become a universal but optional system that is only used by a small number of people as a safety net. In fact with high enough claw back rates for middle to high income earners most people could be given the incentive to sort things out in the private market but nobody would be left without access to medical services if they didn’t.

by the way Jack, you’re forgetting the most important element of Obama’s “racial base”: whites.
There were far more white people who voted for Obama than there were total “Africans and Mexicans” voters combined.
But I guess for old-skool Jack, “white” isn’t a race, it is the absence of race.
Race is “colored”.

gerard, I really should not respond to your desultory salvos as it only gets me into trouble with the blog master. But your comment is a tempting target for some devastating counter-battery fire. There are alot of fools out there trying their hand at psephology and in your case I am in no mood to be charitable.

Try, for once, to give bait-and-switch a miss. I did not deny that the shift in the white majority vote was critical to Obama’s 2008 political victory. I argued that the trend in the colored minority vote is going to be telling for Obama’s future policy direction. I will stick to the psephological surface and avoid plumbing the anthropological depths.

The facts show that in the 2008 election, compared to the 2004 election, colored minorities swung heavily towards Obama DEMs, far more so than the swing in the white majority vote.

In the 2004 Presidential election Bush did surprisingly well in the minority demographic, largely, I believe, owing to the bull run in the property market which especially buoyed his vote amongst the sub-prime demographic. (I noted this back in 2004 when I correctly predicted Bush would win based on the property bubble.)

The CNN exit polls report the following breakdown of the vote by race (slightly adjusted to factor Nader’s vote into Kerry’s column and correcting for the statistical inflation of Bush’s Hispanic vote in Texas):

By contrast in the 2008 election Obama slaughtered McCain (a candidate with fairly liberal views on race) in the minority demographic. TheCNN exit poll reported the following breakdown of the vote by races, with Obama’s respective improvements in parentheses:

So Obama’s positive swing in colored minorities was, on average, about twice as large as his swing in the white majority. This does not mean that the favourable move in the white vote was unimportant to Obama. The white voting population is more than twice the size of the colored voting population. The greater weight in the white vote translates any given change in its proportionate distribution into at least twice as large a change in absolute voting totals.

But the demographic evidence suggests that there is a secular rising trend in the colored minority share of the total voting population. In the political business, votes are deposited debts and debts must be serviced. This is going to be a major factor in the way Obama frames his policy platform ie “paying off ethnological debts”.

I think this demographic sub-text explains the somewhat hysterical response to Obama’s fairly moderate health care reform package. Health care reform is going to be a big boon to young colored minorities (currently not covered by the present system) and will possibly adversely affect older white majority whose share of scarce health resources may decline (“death panels”!). FWIW I support Obama health care reform as I think socialist health administration is more efficient and equitable than capitalist health administration. But as a Machiavellian I must always ask: Quo Bono.

My gut feeling is that the current Tea Party movement is a flash in the pan, generating more smoke than fire and will burn out in a year or so. I therefore tentatively predict that Obama will suffer a bit of a short-term set back in the 2010 mid-term Congressional election. If the DEM vote holds up or improves in 2010 then we are looking at re-alignment.

Over the medium term the absence of a falling-in-sky from this moderate health care reform will reassure white independent voters so he will probably recover and achieve a convincing victory in the 2012 election, better than Bush’s victory in the 2004 election. Over the longer term he will shift the polity further to the Centre-Left, to readjust the welfare state to adjust to fiscal policy and ethno political reality. In effect over the tennies he will do what Clinton wanted to do over the nineties, but more easily due to the weakening opposition.

On a personal note, your instant resort to ad hominum attacks places a question mark against your character. Before you jump to personal conclusions about someones motives you need to make the professional cut when analyzing their actions. In psephological matters you appear to be a duffer hopelessly out of their depth flinging mud instead of sticking to the facts. Not to put too finer point on it, your record does not stack up against mine in either US or AUS elections. I suggest that you make a start by cleaning up your intellectual act. Hopefully this will have a knock-on effect on your moral presentation.

Jack, nobody can ignore the fact that you are nothing short of a psepho nostradamus.

you make sure of that, the way you blow your own horn every post you make.

yes, it’s common knowledge that minority and youth turnout was critical for Obama. but what the hell does “Obama’s racial base” mean? And “Africans”? What are you, a dpz fan?
Ayo my life is like Roots it’s a true story
It’s too gory for them televised fables on cable
I’ma a runaway slave watching the north star
Shackles on my forearm , runnin with the gun on my palm
I’m an African , never was an African-American
Blacker than black I take it back to my origin
Same skin hated by the klansmen
Big nose and lips, big hips and butts, dancin, what

So do you really think that this entire reform of America’s totally dysfunctional, crippingly expensive and obviously unsustainable health system, which basically involves mandates to purchase from private corporations and restrictions on the ability of insurance companies to deny coverage on the basis of pre-existing conditions… is all a matter of repaying “Africans and Mexicans” for their votes? Well you probably share that opinion with the more rabid of the teabaggers, not that you are one.

as for the personal nonsense, well it’s not “jumping” to conclusions after about a hundred of your proudly un-PC comments. kind of obvious that you’re something of an obsessive “racialist”, to use the more charitable term.

but anyway, as for your opinion that the Tea Party movement will be short lived, let’s hope, but that might not be until after the next Murrah.

Another alternative to Medicare would be to keep the existing system in place, but have it that Medicare benefits only kick in once an individual or family has spent more than a certain amount in out-of-pocket medical expenses in a given year. That is, you would pay your own way for things like doctors and specialists until a certain amount, then Medicare would cover the bulk of the cost beyond that. (For low-income earners the amount at which Medicare is phased in would be lower).

This would serve two objectives:
– it would still guarantee everyone had an insurance safety net under them, insofar as individuals and households would not be financially ruined due to excessive medical needs
– it would reduce costs to taxpayers, especially of funding middle-class welfare and churn

Terje, there wouldn’t be much of an administrative problem. Different government departments regularly cross-check information with each other all the time. It would hardly be a big deal for Medicare and the tax office to data match.

When a person receives a medical service, they would simply provide their Medicare number as at present, and either pay the account in full or bill Medicare directly for the Medicare portion. If a person pays an account who is eligible for Medicare they would simply take the receipt to a Medicare office for a rebate, as they do now. If a person opts to bill Medicare who is not yet eligible they would either get a bill back or simply have it credited against their tax return (if they are owed a refund for the financial year or are otherwise in good standing with the tax office).

I think you’re ignoring the privacy issues. The Australia card was a dead duck because of the type of data swapping you are advocating.

Regardless of these irrational concerns, in the end, more data sharing based around a central ID number (with appropriate ringfencing) would be a step forward. It would make it easier to tailor services, do effective planning and much else. Perhaps the best thing would be the scope it would afford to assemble the data needed to undermine irrational scare campaigns!

Fran – All I’ll say on that matter is that it’s a political minefield best negotiated as a separate exercise. In the past both Labor and Coalition governments have looked at it and ultimately backed away.

I didn’t know about the tax situation in Norway. I have heard before that in Sweden all tax returns are publicly available documents. That is, they are not published online but you can search for them in the same way you can search for land titles, the electoral roll etc.

This is an illustration of one of the ways big government inevitably erodes civil liberties and privacy. When the size of government programs expand beyond a certain point, there is a need for more surveillance of the population to ensure people don’t rip the system off.

In point of historical fact, the Swedish and Norwegian approaches to tax open-ness has nothing to do with big government, and much to do with both being small societies that have chosen to try to preserve in modern forms pre-modern forms of community inter-action. From the 16th to the 18th centuries Sweden practiced a form of periodic review of taxation, accompanied by redistributions of accumulated wealth in land to return to more equality.

The point is to limit the need for direct government intervention by heightening consciousness of the interested scrutiny of one’s social neighbours. You can, on the other hand, have a great degree of privacy coupled with Anti-Social Behaviour Orders.

The time has come to take action into our own hands! The washington democrats no longer represent the people of America and its time we take action to stop these socialists before they ruin this great nation. Obamacare took this to the next level, as now we are no longer dealing with just socialists, but murderers. Under these new laws, the unborn will be slaughtered by the thousands, the elderly will be killed based on their “perceived” value to society. THIS MUST STOP

So what can we do, they took away our voice, they took away our rights. But we still have force. We are angry and we can fight. Keep your arms hidden, and keep many of them. If you don’t have any, buy while you still can. We will hit them where it hurts and we will do it together. They cannot stop a network of us when we fight as one, so be prepared.

We fight back in the name of Gods children and all others who will suffer due to our dictators demands. Those lives are worth the same as the arrogant men and women who sit in our capital, and we are prepared to prove it.

There have been some great stories about bricks being thrown, calls being made, and gas lines being cut. Good. We should keep it up, pay a visit to any Dems in your area who voted for it. Use this email as a thread to exchange their personal contact information so we can keep getting to them. They can’t stop us, and they have waged a war they will not win.

If they won’t listen to us, we will make them listen. Damn it, this is our country, and I would sooner die than see it continue to fall at the hands of these murderers. Whose with me? Who will stand with me, and be prepared to fight when the time comes? Lock ‘n load my friends, we’re taking our country back, one dirtbag at a time if we have to.

I read these reactions as confirmation of the scientific theory that Rightwing tendencies are basically a mental illness.

Of course this type of extremism is not new, but the organizational and media infrastructure that supports it is quite unprecedented. What is also unprecedented is the fact that such extreme and clearly potentially violent elements are now embraced by the mainstream Republican party. They cannot distance themselves from the Tea Party, as it is their only ticket, electorally speaking, back into power. Their 2012 frontrunner is Sarah Palin, who has said she’d consider Glenn Beck as a running mate. These two are the leaders of the Tea Party movement. The ball got rolling with Gingrich, but the first black President has finally pushed the Party of Nein off the edge of the spectrum. A majority believes that Obama is a “socialist”, and either believes or is not sure that he was born outside the USA, wants the terrorists to win, and is a racist who hates white people.

Of course it is unlikely (although, depending on the direction the economy takes, not impossible) that the Republicans will return to power in the near future, but what is clear is that if they do, they will make George W Bush look like a good and decent President.

@gerard
No Freelander – they are eating themselves alive….they are scaring normal people with their extremism It is no longer the fictional left that the US voters are afraid of….but you know who. The very same party that has been spreading lies for years now….

Weel yes Gerard – the GOP are suere giving FOX lots of sensationalist news . I bet dear old Rupe isn wishing hoping someone somewhere would start a new war – even a civil war to keep the people buying old fashioned newspapers.

Jack, nobody can ignore the fact that you are nothing short of a psepho nostradamus.
you make sure of that, the way you blow your own horn every post you make.

No, I do not “blow my own horn every post” I make. On psephology, When I am right I say “I was right”. When I am wrong I say “I was wrong.” It just so happens that I the former is more frequent than the latter. (Something to do with my long-winded method and despicable world model, perhaps?) In governance theory this is called “accountability”.

Just now on this thread I corrected myself two of my earlier predictions about Obama’s policy program and political priorities. In an earlier comment I conceded that my prediction that Obama would trade off the warfare state for the welfare state had not happened:

One 2008 prediction of mine that has thus far failed to materialise:
I argued that Obama would tend to strip resources from the warfare state and funnel them to the welfare state.this has not gone through the formality of happening, both arms of the state are growing.

In a follow up comment I conceded that my NOV 2008 prediction that Obama’s commitment to health care reform was half-hearted was more wrong than right:

I just want to go over my Obama model in to weaken or strenghthen assumptions in the light of evidence of his first couple of years….
My prediction that Obama’s health care policies would be tokenist was less than half-right.

I could multiply these examples of “I was wrong” (got the outcome of the QLD election wrong, drat) but you get the picture. My record in predicting Obama’s political behaviour is better than the average pundit (not saying much). Simply because I make predictions where others dont even bother having a go. The more bagging duties I perform now the more bragging rights I get to claim later.

gerard said:

yes, it’s common knowledge that minority and youth turnout was critical for Obama. but what the hell does “Obama’s racial base” mean?

Say what? A moment again you were confidently asserting that

the most important element of Obama’s “racial base”[is]: whites.

Now you are (correctly, at last) saying that minority turnout won the election for Obama. I’m sure an agile dissembler could reconcile this odd couplet but I would get dizzy from all those back-flips.

gerard said:

So do you really think that this entire reform of America’s totally dysfunctional, crippingly expensive and obviously unsustainable health system, which basically involves mandates to purchase from private corporations and restrictions on the ability of insurance companies to deny coverage on the basis of pre-existing conditions… is all a matter of repaying “Africans and Mexicans” for their votes? Well you probably share that opinion with the more rabid of the teabaggers, not that you are one.

I did not say that health care policy was done solely to” repay Africans and Mexicans for their votes”. I argue that minority voting preferences explain Obama’s political prioritization of this policy. Policy supply follows political demand to cash in as votes. The US is a democracy so its not as if there is anything wrong with social groups expressing their demands through votes.

To figure out what I “really think” you might consider reading what I wrote, which pretty clearly indicated that health care reform was worthy enough on its own policy merits:

FWIW I support Obama health care reform as I think socialist health administration is more efficient and equitable than capitalist health administration. But as a Machiavellian I must always ask: Quo Bono

Does that mean I “probably share…the opinion of the more rabid of the teabaggers”? If it does then I suggest your probability estimator is badly in need of a valve job.

It seems to be your standard debating technique to pose a tendentious rhetorical question to some fabricated version of me and then answer it in the most disingenuous possible way. I dont know what you hope to achieve by this apart from exposing yourself to yet more intellectual humiliation.

gerard said:

as for the personal nonsense, well it’s not “jumping” to conclusions after about a hundred of your proudly un-PC comments. kind of obvious that you’re something of an obsessive “racialist”, to use the more charitable term.

I am not an obsessive “racialist”, if by that you mean that I think race is the dominant factor in the evolution of post-modern society. It was Darwin who wrote the “Origin of the Species and the preservation of Favoured Races“? Was he an “obsessive racialist” too?

If you must know, I am a methodological pluralist, allowing casual roles in the distribution of societal values for class, color, cult, clan, creed, cadre, cohort and gender. Generally speaking my basic social model is a bit cruder. Human societies evolve over time in two basic “spatial” dimensions:

Vertical: economic stratification
Horizontal: ethnic “segregation”

And of course the ethnic factor also occupies the temporal dimension, due to the tendency of populations to partially in-breed over time. Otherwise known as biological evolution. I follow Weber in seeing evolution as a process of moving from ethnic folkways to civic forms. But it takes its time and can’t be rushed. Thats why we have conservatives around to pick up the pieces.

Up until the Vietnam War no competent social scientist would have taken exception to this schema which is nothing more than the common sense of anthropology. Since then social scientists have managed to unlearn a vast fund of knowledge accumulated about the bio-diversity of human nature (in race, gender, sexuality and age) and placed it under an index of censorship (political correctness). If it is “obsessive” for me to regularly point out the chronic and acute failure of the media-academia to cover this critical base then I will happily plead guilty. There are others out there such as Steve Sailer (race), roissyinDC (gender), War Nerd (nations) and Christian Slater (cults) who are labouring in the H-BD vineyard. But its a lonely row to hoe.

gerard said:

but anyway, as for your opinion that the Tea Party movement will be short lived, let’s hope, but that might not be until after the next Murrah

Its not my “opinion” that the Tea Party movement will soon run out of steam. It is a prediction based on assumptions that are independently verifiable. If the prediction turns out wrong then I will have to correct those assumptions. This is the method of science, as distinguished from agit-prop or straight out slander which other parties appear to think is a more fun-filled alternative. No names, no pack-drill.

TerjeP (say tay-a) :Gerard – they currently repay nothing under the existing Medicare system so there is nothing lost in the reform I propose. You will have to do better than that.

Terje’s assertion is wrong. Firstly, some people who are now 55+ years have prepaid, relative to those in Terje’s age group, because they used to pay higher top marginal tax rates at some stage of their lives. Second, working people and those on non-labour incomes above a policy determined amount pay x% medicare levy.

EG – Your points are not wrong but you have taken my comment out of context. Gerards complaint about my system was that old people would rack up big debts due to illnesses and then fail to repaying the associated Medicare HECS debt, either because the debt was too large to repay before they die or else because there income was too low to achieve the threshold at which repayment would cut in. Indeed he is correct that some people would not directly repay their Medicare HECS debts due to these circumstances. These debts would be picked up by taxpayers in general. My point is that the taxpayer picks up these cost under the system we operate today, as well as a stack of extra costs, so there isn’t any sense in which this aspect of my reform is worse than the existing system.

well not even Nostradamus had a perfect record Jack, but you seem to think everybody that disagrees with you is engaged in some type of psepho-predictive point-scoring competition, which I’m certainly not.

I’m pointing out that the suggestion that Obama has a “racial base” made of “Africans and Mexicans” implies that most of his base is actually black and latino, when in fact it is still by far majority white, despite the importance of increasing minority turnout. So if there is, in fact, a “racial base”, one would think it should include whites as the largest component.

Yes I can see the point you are trying to make, but sometimes it seems as though you prefer to sacrifice clarity in order to be more politically incorrect.

This specific version of health care reform (mandates without any public option) will primarily benefit the health insurance companies, but admittedly it will, compared to the status quo, also benefit lower-income Americans. And lower-income people in America are disproportionately black and latino, but the majority is still likewise white, and if you’re going to break up the beneficiaries of health care reform by race – the majority of beneficiaries will be white. So I can see your logic when you want to cast this reform as being sometype of political repayment directed specifically to the non-white community, but I don’t think it is a sensible way of looking at it. Any more so than carbon emissions legislation being simply as “Stuff White People Like”.

And I know you’re certainly not a teabagger, however in large part what motivates the teabaggers anger over healthcare is the fact that they are racists who view the reforms in terms of a black President (named Hussein) taking money from whites to give healthcare handouts to blacks and “Mexicans”. That was my point.

Finally, what I meant by a “racialist” is not just somebody who brings race into every discussion, but also somebody who regards the “scholarship” of the Pioneer Fund as serious science.

gerard :
Terje – what would be better is if somebody lucky enough to get cancer at 26 instead of 76 gets to pay for the privilege.

Er, no-one has to pay for the privilege of getting cancer. What is suggested is that you pay for the privilege of gaining access to the services of someone with years of medical training to help you survive the cancer, in the same way you would pay for the services of any other professional.

Your argument seems to be that if something is an apparent need it should be guaranteed free of charge. I guess food and housing should also be provided free of charge. Why should I pay for the privilege of being hungry or needing shelter from the elements?

Gerard – misfortune can be expensive it is true. If you don’t like assuming the risk insurance is an option. If you want to be uninsured then you ought to pay for any consequences. The scheme I have proposed allows people to make that choice without catastophic financial consequences.

p.s. The reality is that health care is never free. It is paid for through taxes, directly or by those that give it through charity. There is no reasonable way in which it can ever be free. What is debatable is the mean by which it should be paid for. You can argue that taxes are better than income contingent government loans if you like but then you ought to actually make the case rather than proclaim a desire for the impossible notion that it should cost nothing.

I think that the case is obvious simply by comparing America’s anti-human abomination of a private-insurance based health care system with that of every other civilized country, like the one that we are lucky enough to live in, no thanks to people like you.

Who needs the choice of whether to pay to be ripped off by a for-profit insurance company or risk total ruin, when in fact we have the third option – living in a decent society with universal public health care, which is what we already have, thank god, and you and I are going to pay for it out of our TAXES, and benefit from it when we need it. And if you don’t like it, you are cordially invited to suck on a government jackboot.

I am also happy for my taxes to subsidize psychiatric treatment and medication to treat those suffering from the mental disorder of right-wing libertarianism, the symptoms of which include a pathological lack of empathy for other human beings, and a desire to increase the misery of those already unfortunate enough to suffer from health conditions.

People choose to go to university and get educated, and presumably they benefit from this education and it allows them to earn a higher income.

People don’t choose to get chronic health conditions, and they don’t benefit financially from this, and in fact those who impose the highest cost on the healthcare system are those with the least ability to repay.

If you never get sick, then you are lucky enough that you shouldn’t be complaining that some of your taxes are going to help those who don’t share in your luck. So what’s the point? Are there a whole lot of high-income people choosing to waste hospital resources? Who decides how much is necessary, how much is wasteful? Is getting sick a choice? What the hell is wrong with you?

@gerard
LOL Gerard….Ill second that. Im sick to death of the words “individual and choice”. Im also willing to subsidise pychiatrists to attend to those getting madder amongst us…really, 50 years ago who would have thought the rightwing would have / could have ended up this mad? But really, when you think about it…the seeds started sprouting as long ago as McCarthyism…

They rely heavily on war (except when they up up to their necks in foreign mud, destruction and dead or disabled soldiers at home who may need healthcare now that some are coming home ….I forgot some of the soldiers probably cant afford US healthcare).

Add to a lack of empathy so often seen in this sector of wringwingnutism a true willingness to exploit the lives, choices and freedoms of others.

Gerard, I seem to recall on a previous thread about Austrian economics you claimed that one of the flaws of the Austrian school is an excess of moralising over empirical rigour.

Your last post is a perfect illustration of how it is really social democratic perspectives that tend to suffer from an excess of sanctimonious moralising. Pot meet kettle.

I guess there is not much point in arguing the case, as you know in your heart what is pure and right, us free-marketeers are all a bunch of evil enemies of civilisation, and that is all there is to it.

Who needs the choice of whether to pay to be ripped off by a for-profit insurance company or risk total ruin

That wasn’t the choice I was advocating. I outlined a system that allows people to avoid financial ruin or financial hardship even if they elect to have no insurance. You can point to America and if you wanted you could even make comparisons between Australia and America (I note that you have not made any comparisons just asserted that we could) however that wouldn’t be overly relevant because I have not advocated the American system.

Terje is happy to slap a huge increase on the taxes on those unfortunate enough to have required expensive medical assistance, if it means a little reduction in the taxes of those who are not that unfortunate. Even if repayment is contingent on meeting a certain level of income, that’s still financial hardship. I have a huge HECS debt, and believe me, it sucks. However it was my choice to study for years on end, so I can’t really object. Getting cancer, however, is not a choice. In a civilized society, whether you have it treated is not a choice either.

I guess there is not much point in arguing the case, as you know in your heart what is pure and right, us free-marketeers are all a bunch of evil enemies of civilisation, and that is all there is to it.

That’s not quite all there is to it, but almost. I do, in fact, think your so-called “free-marketeer” opinions are evil, because they are.

The difference with the Austrians is firstly that they deny being moralistic, whereas I’m quite happy to admit to it. The second difference is that their morals are basically the polar opposite of what basic moral principles have been common to most human societies for thousands of years. I wouldn’t call myself a Christian, but you get the point.

Terje is happy to slap a huge increase on the taxes on those unfortunate enough to have required expensive medical assistance, if it means a little reduction in the taxes of those who are not that unfortunate.

If the medicare levy was an honest reflection of the cost of government funded health care then it would be around 8%. As such the potential tax savings are not little.

Even if repayment is contingent on meeting a certain level of income, that’s still financial hardship. I have a huge HECS debt, and believe me, it sucks.

Yes paying the bills sucks. But it isn’t the definition of financial hardship.

Thanks Terje for ignoring the main points that I made. Financial hardship comes on a sliding scale. Taking on a HECS debt was a choice. Getting sick isn’t. And your stupid rotten plan wouldn’t save any money, it would just change who was paying it. That is, unless you think there’s some widespread wastage of hospital resources by rich people, which simply isn’t the case. More to the point, your plan will never be implemented, because it is so self-evidently dreadful that no politician would touch it with a ten mile pole. The best thing about democracy, even our very imperfect version of it, is that it protects society from twisted ideas like yours. So just like your similarly ridiculous plan to deny the vote to poor people, it is not worth discussing, thank god, except maybe at the annual general phone-booth-sized meeting of LDP psychopaths.

well not even Nostradamus had a perfect record Jack, but you seem to think everybody that disagrees with you is engaged in some type of psepho-predictive point-scoring competition, which I’m certainly not.

My primary “competition” is my previous personal best, not “everybody who disagrees” with me. PB’s are the quickest benchmarks of progress.

Most other commenters arent even in the race. They dont bother to build testable models, cite comparative stats or do any kind of check on their predictions. They are just barracking. So when someone enters the ring and shapes up I am entitled to raise my guard and throw my favourite punch: what is your pespho-predictive score?

Frequently this lands a knock-out blow. A few comments back you challenged my psephologic analysis of Obama’s victory. In the space of a few comments I forced you to make a complete back-flip on the source of Obama’s political base, flipping from the white majority to increased colored minority turnout. So maybe its time you took your own advice and stepped out of the ring.

gerard said:

I’m pointing out that the suggestion that Obama has a “racial base” made of “Africans and Mexicans” implies that most of his base is actually black and latino, when in fact it is still by far majority white, despite the importance of increasing minority turnout. So if there is, in fact, a “racial base”, one would think it should include whites as the largest component.
Yes I can see the point you are trying to make, but sometimes it seems as though you prefer to sacrifice clarity in order to be more politically incorrect.

I do not “sacrifice clarity in order to be more politically incorrect”. I refuse to sacrifice veracity to be politically correct.

You are still missing or misrepresenting my point. I did not “impl[y] that most of [Obama’s] base is actually black and latino”. In typical gerard style you just made that up, proving my point about your dodgy intellectual ethics. Try quoting verbatim for once, its more transparent.

I stated that the recent change in both the turnout and partisan alignment of the colored minority vote was a critical factor in the change in Obama-DEMs total vote. (“Change we can believe in”, finally.) What counts in political and economic competitions is variations at the margin (marginal voters, marginal buyers etc). The change in the colored minority vote was proportionately twice the change in the white majority vote. That kind of change makes a difference in both political outcomes (DEMs v REPs) and policy priorities (eg health care reform v financial reform).

No one is arguing, at least not me, that whites are not the DEMs biggest racial block, about 70% for generic DEMs according to my calculations. Its not surprising that whites comprise 70% of the DEM vote. They are about 70% of the total US population, thats why they are called the “majority”. And they are also significantly more likely to vote than colored minorities. Using CNN exit poll data I have broken down the Pelosi-DEMs 2006 Congressional elections vote column by race:

(Note the RACE% is calculated off the DEMs 53% share of the total primary vote, then converted to DEM-only vote percentage in parentheses.)

To determine Obama’s demographic political effect we need to compare the 2006 Congressional election to the 2008 Presidential election. Using CNN exit poll data I have broken down the Obama-DEMs 2008 Presidential election vote column by race:

The Pelosi-DEMs made major inroads on the white vote, raising their share of it by 5%, from 42% in 2004 to 47% in 2006. But in the 2008 Presidential elections the Obama-DEMs share of the white vote slipped back to 43%, even as they maintained their 53% share of the overall popular vote.

Obama made a major difference in the racial composition, if not the overall size, of the DEM vote. In 2006 the Pelosi-DEMs got 29% of their vote from colored minorities. But in 2008 the Obama-DEMs got 40% of their votes from colored minorities. Thats a sizeable (11%) demographic shift over a such a short period.

gerard said:

So I can see your logic when you want to cast this reform as being sometype of political repayment directed specifically to the non-white community, but I don’t think it is a sensible way of looking at it. Any more so than carbon emissions legislation being simply as “Stuff White People Like”.

I have never cast this reform [solely] as being some type of political repayment directed specifically to the non-white community.

Twice already I have stated that health care reform was worthy enough on its own policy merits…But as a Machiavellian I must always ask: Quo Bono.

Do you need me to say everything three times before it sinks in? [bangs head against wall as if talking to a particularly obtuse child].

Obviously the magnitude of Obama’s political debits conditions the priorities of his policy program. He has a finite supply of political capital. He could have tackled financial reform or energy policy first. Instead he chose to prioritize health care reform, because it made political and policy sense to do so.

This is risky political move to make in regards to the white majority vote, as the Tea Party-animal reaction shows. But its more popular amongst the colored minorities who are not very well covered by existing private health care insurers. The WaPo spells out the way that Obama’s health care reform is, in political terms, a DEM base-consolidating move:

the uninsured are already part of the Obama coalition. Recent Washington Post-ABC News polls found 57 percent of the uninsured either favor or lean toward the Democratic Party, and 32 percent favor the GOP.

In the near term, “I don’t expect to see some big segment of new voters attaching themselves to the Democratic Party, because of health care,” said Mark Mellman, a Democratic pollster….

He said the uninsured come from such Obama-leaning groups that in some ways passing the bill was “preaching to the choir.”

Political demand and policy supply are not processes that go on in parallel universes. We dont know what benevolent philosopher kings would do in Obama’s place. We live in a Machiavellian world, not a Platonic one. So in this world, interest group political calculations must play a part in predicting governmental policy implementations.

Not. Rocket. Science.

gerard said:

And I know you’re certainly not a teabagger, however in large part what motivates the teabaggers anger over healthcare is the fact that they are racists who view the reforms in terms of a black President (named Hussein) taking money from whites to give healthcare handouts to blacks and “Mexicans”. That was my point.

Actually you have the identities of your point-makers exactly back to front. It was my point that health care reform has a “disparate impact” on the races. And of course this totally undermines your earlier point that Obama’s racial base was the white majority, a large fraction of which demographic are not thrilled by his health care reform. FTR, so you can’t wiggle off the point, I will spell it out again. In an earlier comment, I clearly stated that the Tea-Party political angst had a racial “sub-text”:

Of course in policy terms the Tea-Bag “racists” may be quite correct about the racially re-distributive effect of health care reform. In racially diverse societies entitlement reforms often turn into “Who-Whom” robbing-Peter-to-pay-Paul zero-sum games. There is some hope that Orzagist “bending the cost curve” economies may pay for the expansion of coverage and turn health insurance reform into a positive-sum gain. I will believe it when I start to hear the private insurers scream.

In political terms, most new presidents suffer a set-back in their first Congressional elections, its a presidential rite of passage. And the REP’s white base is somewhat aroused by health care reform, which is always tends to raise the REP vote since voter turnout is the key to winning US elections.

Over the shorter-term I expect the DEMs will pay a political price for pushing through health care policy. Probably lose a swag of seats in the 2010 mid-term Congressional elections. (Perhaps that explains the DEMs “fierce urgency of now” on this question.)

But over the longer term I think the Tea-Party-goers will eventually drain the Punch Bowl dry and drift off home. This always happens to the paranoid elements of the US Right, they periodically arc up and then withdraw from public life. Particularly when they find out that Obama’s health care reforms will not require them to throw their white granny off the train.

gerard said:

Finally, what I meant by a “racialist” is not just somebody who brings race into every discussion, but also somebody who regards the “scholarship” of the Pioneer Fund as serious science.

I bring up race into relation to many debates into the US political scene because it is always a relevant, and frequently the dominant, factor in a few personal, many professional and almost all political relations. This is bleedin’ obvious to anyone who has lived there for an extended period, as I have. It should also be obvious to anyone who has a basic grasp of anthropological theory, which you don’t.

My comment privileges do not extend to making substantive appraisals of the Pioneer fund scholars. I can probably get away with saying that a few are unsavoury in ethics and a some more are dodgy in epistemics. But amongst its number the Fund can count “serious scientists” such as Bouchard, Jensen, Eysenk and Gottfriedson. Not to mention Murray, who Flynn described as “a good social scientist and a decent human being”. Perhaps you can show us that you know something that these scholars don’t, rather than just indulging in knee-jerk, two degrees of separation, point-and-splutter condemnation.